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C� <br />City of Santa Ana <br />Clerk of the Council <br />AGREEMENT TERMINATION FORM <br />Please complete this form in its entirety when the attached agreement and all <br />amendments (if any) are no longer in effect. <br />Note: If your agreement is grant related, please ensure that all grant retention requirements GLER <br />have been satisfied prior to signing the termination form. I i <br />Is the agreement(s) a permanent record? Yes _ No _✓ <br />Return form to the Clerk of the Council Office (M-30). <br />Call 647-1520 if you have any questions. <br />The agreement with <br />S ttU v_ -I <br />A-2020-043-14 <br />No. was completed on <br />(List all amendments. Use space below N needed.) <br />Department: <br />Phone/Ext.: <br />Signature: <br />Date: <br />c9agreementi;Vom skform - agreement termination form--goldenrod.doc <br />COTC Office Use Only <br />OF THE COUNCIL <br />V 31123 PN3:57 <br />final payment has been made. <br />